Migraine surgery is successful in teen patients with severe migraine headaches who are non-responsive to typical treatments, according to a new study published in the journal Plastic and Reconstructive Surgery.
“Our data demonstrate that surgery for refractory migraine headaches in the adolescent population may improve and potentially completely ameliorate symptoms for some,” writes researcher and surgeon Bahman Guyuron, M.D., an American Society of Plastic Surgeons (ASPS) Member and emeritus professor of plastic surgery at Case School of Medicine, Cleveland, and colleagues.
The study involved 14 patients with migraines under the age of 18. The surgery targets “trigger sites” in the nerve branches that tend to induce headaches. These trigger sites are detected using a constellation of symptoms, nerve blocks, ultrasound Doppler, and computerized tomography (CT) scans.
Guyuron developed the migraine surgery procedure after seeing that some migraine patients had reduced headache activity after undergoing cosmetic forehead lift procedures going back to year 2000.
All teen patients in the study suffered from debilitating migraine attacks that continued despite taking prescribed medications. This included 11 females and three males, with an average age of 16 years.
One patient underwent two procedures targeting different trigger sites. Average follow-up was about three years, and at least one year in all patients.
In this group of young patients, surgery was extremely successful in reducing migraine headaches. Average headache frequency decreased from 25 per month before surgery to five per month afterward. Average migraine severity score decreased from 8.2 to 4.3 on a ten-point scale.
The average length of migraine attacks also decreased from about 12 hours to four hours. Five of the 14 patients were completely migraine-free after surgery. One patient had no change in migraine frequency, although attacks were shorter and less severe.
Migraines are a common health problem in children and teens, and they have a significant impact on mental and physical health for patients and their families. Unfortunately, treatment options are limited. Research has found that nearly one-fourth of children with neurologist-diagnosed migraine don’t respond to recommended medications.
“This represents a large group of adolescent migraine patients with continued symptoms in spite of specialized medical treatment,” write the researchers.
Although the study is small and preliminary, the results suggest that migraine surgery, as in adults, is safe and effective in teen patients. No complications were encountered in this group of young people.
Surgery is performed only after careful evaluation in patients who don’t respond to standard migraine treatments, who have identifiable trigger points and whose family history confirms the continuation of migraines from childhood to adulthood.
“Identifying the adolescent patient who would benefit from surgery is the most important aspect of surgical intervention,” writes Guyuron and team. The researchers emphasize the need for “more in-depth and prospective studies” to further establish the effectiveness of surgery, and to weigh the risks and benefits of this procedure for younger patients.
The research team has published 24 articles in peer-reviewed journals on this topic, reporting the effectiveness of the surgery, and they have another 12 research projects underway. Five additional independent centers have confirmed Guyuron’s findings.
Source: Wolters Kluwer Health